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. 2024 Apr 25;14(5):425.
doi: 10.3390/brainsci14050425.

Efficacy of a Soft Robotic Exoskeleton to Improve Lower Limb Motor Function in Children with Spastic Cerebral Palsy: A Single-Blinded Randomized Controlled Trial

Zhichong Hui  1 , Weihang Qi  1 , Yi Zhang  1 , Mingmei Wang  1 , Jiamei Zhang  1 , Dong Li  1 , Dengna Zhu  1   2
Affiliations

Efficacy of a Soft Robotic Exoskeleton to Improve Lower Limb Motor Function in Children with Spastic Cerebral Palsy: A Single-Blinded Randomized Controlled Trial

Zhichong Hui et al. Brain Sci. .

Abstract

Purpose: Soft robotic exoskeletons (SREs) are portable, lightweight assistive technology with therapeutic potential for improving lower limb motor function in children with cerebral palsy. To understand the effects of long-term SRE-assisted walking training on children with spastic cerebral palsy (SCP), we designed a study aiming to elucidate the effects of SRE-assisted walking training on lower limb motor function in this population.

Methods: In this randomized, single-blinded (outcome assessor) controlled trial, forty children diagnosed with SCP were randomized into the routine rehabilitation (RR) group (N = 20) and the SRE group (N = 20) for comparison. The RR group received routine rehabilitation training, and the SRE group received routine rehabilitation training combined with SRE-assisted overground walking training. Assessments (without SRE) were conducted pre- and post-intervention (8 weeks after the intervention). The primary outcome measures included the 10 m walk test (10MWT) and the 6 min walk test (6MWT). Secondary outcome measures comprised the gross motor function measure-88, pediatric balance scale modified Ashworth scale, and physiological cost index.

Results: Both groups showed significant improvements (p < 0.01) across all outcome measures after the 8-week intervention. Between-group comparisons using ANCOVA revealed that the SRE group demonstrated greater improvement in walking speed from the 10MWT (+6.78 m/min, 95% CI [5.74-7.83]; p < 0.001) and walking distance during the 6MWT (+34.42 m, 95% CI [28.84-39.99]; p < 0.001). The SRE group showed greater improvement in all secondary outcome measures (p < 0.001).

Conclusions: The study findings suggested that the integration of SRE-assisted overground walking training with routine rehabilitation more effectively enhances lower limb motor function in children with SCP compared to routine rehabilitation alone.

Keywords: cerebral palsy; energy expenditure; gross motor function; robot-assisted therapy; soft robotic.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study.
Figure 2
Figure 2
(A) Relink-ANK soft robotic exoskeleton, (B) SRE-assisted overground walking training, (C) SRE-assisted overground walking training with a walking aid.
Figure 2
Figure 2
(A) Relink-ANK soft robotic exoskeleton, (B) SRE-assisted overground walking training, (C) SRE-assisted overground walking training with a walking aid.
Figure 3
Figure 3
(A–C) indicate the correlation between SRE-induced changes in energy expenditure and the clinical assessment scales GMFM-D, E, and PBS, respectively. Abbreviations: SRE, soft robotic exoskeleton; GMFM-D, gross motor function measure-D zone; GMFM-E, gross motor function measure-E zone; PBS, pediatric balance scale; PCI, physiological cost index.
See this image and copyright information in PMC

References

    1. Nahm N.J., Graham H.K., Gormley M.E., Georgiadis A.G. Management of hypertonia in cerebral palsy. Curr. Opin. Pediatr. 2018;30:57–64. doi: 10.1097/MOP.0000000000000567. - DOI - PubMed
    1. Hanssen B., Peeters N., Vandekerckhove I., De Beukelaer N., Bar-On L., Molenaers G., Van Campenhout A., Degelaen M., Broeck C.V.D., Calders P., et al. The Contribution of Decreased Muscle Size to Muscle Weakness in Children with Spastic Cerebral Palsy. Front. Neurol. 2021;12:692582. doi: 10.3389/fneur.2021.692582. - DOI - PMC - PubMed
    1. Palisano R., Rosenbaum P., Walter S., Russell D., Wood E., Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev. Med. Child Neurol. 1997;39:214–223. doi: 10.1111/j.1469-8749.1997.tb07414.x. - DOI - PubMed
    1. Wu M., Kim J., Gaebler-Spira D.J., Schmit B.D., Arora P. Robotic Resistance Treadmill Training Improves Locomotor Function in Children With Cerebral Palsy: A Randomized Controlled Pilot Study. Arch. Phys. Med. Rehabil. 2017;98:2126–2133. doi: 10.1016/j.apmr.2017.04.022. - DOI - PMC - PubMed
    1. Rosenbaum P., Paneth N., Leviton A., Goldstein M., Bax M., Damiano D., Dan B., Jacobsson B. A report: The definition and classification of cerebral palsy April 2006. Dev. Med. Child Neurol. Suppl. 2007;109:8–14. - PubMed

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